1990-2019 年间中国恶性间皮瘤负担及 2029 年前的预测

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摘要

方法从全球疾病负担(GBD)2019数据库中获得1990-2019年中国恶性间皮瘤患者的数据,包括年度病例和死亡数据,以及不同年龄组恶性间皮瘤的发病率、死亡率和残疾调整生命年(DALYs)的年龄标准化率。1990-2019年期间的时间趋势是通过使用95%置信区间(CI)的Joinpoint回归模型进行分析的,而到2029年的预测则是通过贝叶斯年龄-时期-队列模型计算的。有关中国石棉生产和消费的数据来自美国地质调查局 1996-2023 年期间的《矿物商品摘要》。结果 我们观察到,在过去 30 年中,新发病例和死亡病例显著增加,新发病例从 1990 年的 1193 例增加到 2019 年的 2815 例,死亡病例从 1990 年的 1134 例增加到 2019 年的 2773 例。我们发现,70 岁以上人群的发病比例增加了约 6%(2019 年为 30%,1990 年为 24%),而 70 岁以上人群的死亡比例也出现了类似的上升。此外,与女性相比,男性在各年龄组中因MM导致的残疾调整寿命年数要高得多。自2012年以来,中国的石棉消费量急剧下降,并于2017年跌至230千吨的谷底。到2029年,预计年龄标准化的发病率和死亡率都将达到1.2/100万。结论我们首次利用GBD数据发现,在过去30年中,中国人口的MM负担显著增加,并将在未来十年中继续增加,这表明中国迫切需要全面禁止使用温石棉。
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Burden of malignant mesothelioma in China during 1990–2019 and the projections through 2029

Objective

To provide the most up-to-date data on the burden of malignant mesothelioma (MM) and the projections through 2029 in China.

Methods

Data on patients diagnosed with MM from China during 1990–2019 were obtained from the Global Burden of Disease (GBD) 2019 database, including annual cases and deaths data and age-standardized rates of incidence, mortality, and disability-adjusted life-years (DALYs) associated with MM among different age groups. Temporal trends during 1990–2019 were analyzed by the Joinpoint regression models using 95% confidence interval (CI), while the projections through 2029 were calculated by the Bayesian age-period-cohort model. Data on the production and consumption of asbestos in China were obtained from the United States Geological Survey on Mineral Commodity Summaries during 1996–2023.

Results

We observed a significant elevation in incident new cases and deaths over the last 3 decades, increasing from 1193 in 1990 to 2815 in 2019 for incident cases and from 1134 in 1990 to 2773 in 2019 for death cases. We found a roughly 6% increase in the proportion of incident cases for those aged >70 years (30% in 2019 versus 24% in 1990), while for the proportion of deaths similar elevation for those aged >70 years was found. Additionally, men had significantly higher DALYs due to MM across age groups compared with women. Asbestos consumption in China dramatically dropped since 2012 and reached the bottom in 2017 with 230 kilotons. By 2029, the projected age-standardized rate for incidence and mortality is expected to reach 1.2 per million for both.

Conclusion

We found, for the first time using GBD data on the Chinese population, that the burden of MM has been significantly increasing in China over the last three decades and will continue to increase in the upcoming decade, suggesting an urgent need for a complete ban on chrysotile asbestos in China.

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70 days
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